Cervical screening & Colposcopy

Question 1

describe structure of screening programme? (4)

Answer 1

25-60 year olds
3 yearly smears
undertaken in primary care
coordinated through electronic call and recall systems

Question 2

What are the possible cytology results and the corresponding management?

Answer 2

Normal- routine recall
Inflammatory- repeat 3 months 
Borderline-repeat 6 months
Mild dyskaryosis- repeat 6 months 
Moderate dyskaryosis- refer colposcopy
Severe dyskaryosis- refer colposcopy- refer colposcopy 
Glandular abnormalities- refer colposcopy 
?Invasive- refer urgent colposcopy

Question 3

What is colposcopy?

-management options?

Answer 3

-magnified inspection of the cervix and use of stain to identify abnormality

-biopsy and follow up
biopsy and treat wont cold coagulation
LLETZ (large loop excision of the transformational zone

Question 4

name the two colposcopic stains and their use?
1- 5
2- 2

Answer 4

Acetic acid
goes white with abnormality
can see extent of lesion, density, mosaic, punctation and abnormal vessels

Iodine
positive is brown= normal
negative is absence of stain = abnormal

Question 5

Following assessment

• results of histology can be?
• treatment?

Answer 5

CIN 1, 2, 3
cGIN
Cancer

-Cold coagulation
(hot problem causes cells to burst)
LLETZ
(electrosurgical wins cute through tissue)

Question 6

What is test of cure?

Answer 6

combined smear and HPV test
Doble negative- 3 yearly repeat smear
if + then need another colposcopy